The Game of Death – New Players

Warning: If you want to avoid the topic of death and dark humour read no further.

Covid 19 has made people think and talk about how people should die, with emphasis on not being alone, preferably with family. Covid patients in isolation have been unable to see loved ones.

In reality most of us cannot choose where to die or plan the scenario; victims of murder or major disasters certainly don’t have the luxury of dying in their own beds comforted by family. Awful circumstances such as terrorist attacks find total strangers holding the hand of a dying person, giving their death some dignity. As no one comes back to tell us, we cannot know if the surroundings and company or lack of it make any difference to their own unique internal solo journey. Celebrities often seem to have died ‘peacefully at home with their family present’ but folk lore and family tales seem to indicate that dying people often wait till the very moment loved ones pop out of the room.

Most terminally ill people will probably get the chance to opt for palliative care at home, though it can’t be guaranteed; they may need to go to hospital or a hospice eventually, but Covid has made it even more desirable to stay at home and leave hospital beds free for others. Unless everyone in your family is a medical person, carers will need help along the way or near the end; team work and various bits of equipment are required to make life easy for patient and carers. There is nothing to stop you ordering wheelchairs and all sorts on Amazon and getting next day delivery, but the National Health Service is geared up to lend what you need and the various teams helping you will be busy arranging equipment. The largest item is the hospital bed; you might die in your own home, but probably not in your own bed, however romantic that looks in films. The beds have to be plugged in and do all sorts of things. The bed and other items come with wheels and stiff pedal brakes impossible to put on or off if you are only wearing your slippers!

In the first few months of the lockdown I coped fine by myself with Cyberspouse. District nurses were trying to avoid going in any homes, but they phoned regularly with advice and to arrange some of the medications. They were ready to come out with their protective gear if necessary. Cyberspouse was happy not to have any visits, medical or otherwise, relaxing at home in the exceptionally sunny weather we had.

Later on, family help was more vital than keeping isolated and they took turns to come and stay; it was only in the last ten days that the district nurses came and arranged for Marie Curie nurses to parachute in with four visits a day. A helpful bright yellow book arrived promptly in the post. We were also glad a few times to ring the emergency numbers that had been sitting by the phone for months; night duty district nurses and 111 doctors. Marie Curie were excellent, compassionate and caring ladies and one chap. Visits rapidly increased and they made sure I had a night nurse for what turned out to be the last night, one of the few nights I was going to be by myself. They told me I was going to have wonderful Linda who had been doing the overnighter ‘forever’.

Linda arrived with a huge bag, rather like a mature Mary Poppins. I explained yet again that none of the family lived nearby, but they had all been to visit and my daughter was coming back the next day. It was a busy week in real life with two grandchildren just back in the UK and starting a new school and my daughter’s son starting school! Younger son had just got engaged. Linda was there to make sure Cyberspouse was comfortable, to organise the practicalities and make sure I didn’t miss the moment…

I later got a nice card from Marie Curie and they have rung me a few times to see how I am getting on. They are a charity well worth supporting.

Handy Home Hints

You might think your loved one is past the point of seeing the GP, but it is the GP who has to prescribe the drugs and you will have to go and sign for the ‘just in case’ controlled drugs as well as collecting various ongoing prescriptions.

It is helpful if someone in the family works for the NHS or has a friend in palliative care nursing … my daughter is a physiotherapist and had that very friend to ask for advice. She always made lists of questions and sounded professional on the phone, so we were well prepared.

After the death a doctor has to come and certify the death, either the GP or the on call ( 111 ) doctor at night. After that you must call the funeral director, but you can decide if you want them to come as soon as possible or wait a while.

Afterwards you will have to return all the drugs to a pharmacy, especially the controlled drugs, but unused needles have to be returned to the doctors’ surgery.

Darkly Funny Moments.  

The next day, Thursday, the funeral directors phoned to say they had not had the notification from our GP of the death. The on call night duty doctor had sat at the kitchen table typing into his lap top, saying ‘everything is going straight through to your doctor’s surgery’ but my writer’s mind thought ‘I have no proof he’s even been here, no piece of paper, was he actually a doctor?’ I was slightly reassured that nurse Linda knew him. When my daughter tried phoning our surgery she couldn’t get through and in the end resorted to using her internal NHS email. Luckily the information did end up in the right place.

One thing the district nurses requested unsuccessfully was a hospital bed extension, we had been expecting it for weeks. When a chap with a truck arrived at the door on Thursday morning I thought he was very quick to collect the hospital bed until he said cheerfully ‘I’ve brought the bed extension’. Poor bloke was embarrassed when I apologised that it was too late.

We had not seen much of the palliative care team from the local hospital who originally got us organised. One of the nurses had phoned the previous week saying ‘I’ll touch base with you on Friday.’ Sure enough on Friday the phone rang and she said brightly ‘Just calling to touch base’… so I had to tell her the news.  

Because of  Covid we were saved a trip to the registry office; instead I had a nice phone chat to Polly the registrar including Cyberspouse’s no funeral request. After taking most of the details she asked me my occupation. Oh oh, was I going to fail this part? I replied that I had done all sorts of things and she said ‘How would you like to be known in a hundred years?’ Well who in a hundred years would know I didn’t earn a living at it, so of course I replied  ‘A writer!’

https://www.mariecurie.org.uk/help/support/terminal-illness/preparing/what-to-expect

Unmasked

After months of indecision and confusion from our leaders we are finally wearing facemasks – a bit. On public transport and for customers in shops it’s official, though without much hope of enforcement. Staying at home as a full time carer, the only shop I have been to is the tiny Boots’ pharmacy attached to our doctors’ surgery. Actually lots of people aren’t going to real shops; busy working couples who have been doing on line shopping for years and the ‘vulnerable’ who have discovered on line shopping and don’t trust anything the government says.

At our little chemist the staff have always worn masks and only let one person in at a time, so it feels safe, with the added benefit of privacy for discussing personal medical stuff. But I miss the jolly days crammed in with bored toddlers and having a joke with bored adults as we all waited and wondered who would hit the jackpot and get their prescription next or at all. And of course listening in to other people’s strange medical problems or listening in to the medical problems of strange people…

In Covid times we wait outside, not too many people, but with plenty of opportunity for confusion. You may think someone is pushing in, but they are making their way to the outer door of the surgery to ring the bell and report to the all powerful receptionist, who tells them to wait outside until summoned on their mobile phone; leaving them with the dilemma of which queue to stand in. The rest of us are either queueing to go in to the pharmacy or have already been in but have to wait for our prescriptions.

On my first visit with official mask wearing I got a tickly cough ( NOT a Covid cough ) as soon as I got inside – what to do? Rip off mask and take a sip out of my water bottle? NO, not allowed to touch mask let alone remove it.

One of the regular staff is always friendly and helpful, but a good while ago he was away and when he came back had lost his voice, reduced to a whisper, that was okay without a mask… I had no idea if he could hear my mask voice properly; I was there to collect new prescriptions, with either no idea what they were called or how to pronounce them and also to explain that as we were having a regular medicine in liquid form could we cancel the repeat prescription for the capsules… He checked the computer screen and the bag of medicines and the forms, but he may as well have been speaking in Martian. I understood only his last whispered words Address, post code – for a moment I thought the mask would make me forget my own address, but I managed that bit and just hoped what was in the heavy bag was all the correct stuff.

As I was leaving I did feel, in my stuffy mask, on a hot day, looking forward to taking it off as soon as I got round the corner…  I did feel at last I was part of the Covid Community.

As I was leaving, another staff member came out to give a lady her prescription and asked her address, the woman instinctively pulled down her mask to say her address…

The NHS

I was going to write about The NHS weeks ago, but events kept overtaking me and the subject.

‘The National Health Service is the publicly funded healthcare system of the United Kingdom. It is made up of four separate systems that serve each part of the UK: The National Health Service in England, NHS Scotland, NHS Wales and Health and Social Care in Northern Ireland. They were established together in 1948 as one of the major social reforms following the Second World War. The founding principles were that services should be comprehensive, universal and free at the point of delivery. Each service provides a comprehensive range of health services, free at the point of use for people ordinarily resident in the United Kingdom, apart from dental treatment and optical care. The English NHS also requires patients to pay prescription charges with a range of exemptions from these charges.’

https://www.nhs.uk/

Often the NHS is only in our thoughts when we are having our own personal dramas. Sometimes it is in the news for the wrong reasons, when things go drastically wrong. At present it is in the news all the time, it IS The News. The system that has cared for most of us from before we were born until we take our last breath is now responsible for steering the UK through the world wide pandemic. Whilst many people have been told not to go to work and stay at home, NHS staff are hardly seeing their homes. Government quickly forgets all the cut backs, poor pay for some, meddling, outsourcing and attempts to sell bits off that put the NHS at risk and expect all the staff to rise to the challenge… and they have. Perhaps when or if this is over those in power will do the right thing, instead of the public having to continually sign petitions pleading for our national treasure to be protected.
I recently finished reading Adam Kay’s Book This Is Going to Hurt: Secret Diaries of a Junior Doctor and reviewed it on Goodreads.

‘When my planned caesarean for our first baby ( breech ) turned into a 1am Sunday morning dash to Queen Charlotte’s Hospital a week early, one of the staff said ‘You’re in luck, the registrar’s on tonight’ I wondered what would have happened if he hadn’t been on. They may also have said I was lucky it was a quiet night. Anyway, everything proceeded quickly. When the same early imminent arrival happened with my third caesarean the same hospital was busy with a worrying lack of progress; the surgeon told me he had another emergency caesarean to perform and he had rung the consultant – for advice, not actually to come in; consultants don’t come in during the night as you will find out when you read this book! The anaesthetist said he had been on for 24 hours, I was shocked, but this was no doubt the norm, then and now. Adam Kay’s book is very funny, but there are dark moments and to an outsider it seems a realistic portrayal of a medical career, the dedication of those who work for the NHS and the cavalier attitude of management and government to our most important and treasured institution. Many readers will find anecdotes that relate to their family’s experiences and people who enjoy medical things are bound to relish this book.’

https://www.goodreads.com/book/show/35235302-this-is-going-to-hurt

Adam Kay is now a writer and comedian, no longer a doctor. Is the NHS perfect? Of course not, it’s staffed by human beings, some not as caring as they should be, some arrogant and others too scared to be whistle blowers. Tales of what went wrong and what went right are for another time.
One of the sad aspects of the virus tragedy is that the seriously ill are in isolation, they are not able to see any loved ones. Nor do they have the comfort of seeing the compassionate faces of the medical staff, who in all their protective gear must look like aliens or spacemen to their patients. Those of us who have had treatment in normal times know staff come from all over the world, international cooperation at its best.

Friday Flash Fiction 400 – The Yellow Door

‘So Mrs Green, take this prescription with you and leave by the second door on the left.’

Mrs. Green trudged wearily along the dreary corridor of the surgery then hesitated at the yellow door. She had never noticed it before, there was no number or name. Warily she pushed it open and was blinded by a bright light, sunlight. Shielding her eyes, she realised she was in a beautiful walled garden. The old lady had often wondered what lay at the back of the doctors’ surgery.

A child’s laughter floated towards her and a little figure appeared running along the gravel path. The child stopped then ran back to a young woman sitting on a garden seat, head back, eyes closed. The older woman approached, but seeing the blissful expression on the mother’s face she perched herself on the other end of the bench, not wishing to disturb her. The child shot off again and Mrs. Green looked around for a father or granny, concerned he might run away, but the garden was safely enclosed. She noticed other seats, other people sitting or strolling and up in an old apple tree several children were perched.

The old lady unfolded the prescription.

NHS Therapy 3,000 hours of sunshine,  to be taken daily. If you miss a dose take double the next day.

There must have been a mistake, now she would have to go back and ask about her tablets, but in the meantime she needed a rest. The scent of the flowers brought back childhood memories. A stroll along the path to admire the herbaceous borders would be very pleasant, but first she would close her eyes and feel the sun on her face. The happy chatter of the children was soothing and she was so glad she had come to the doctors’ this morning, although she could not recall which of her conditions she had come to see him about.

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Doctor Brown gazed out of the upstairs window of the staff room and turned to his colleague.

‘Who would have guessed it would work so well, of course this weather helps, but rain hasn’t put off the diabetes type 2 group. They were glad of it after all the planting they’d done.’

‘Yes, the pharmacist says she’s issuing half the prescriptions, especially for anti-depressants and blood pressure medication.’

‘…and the attention deficit disorder group are doing much better at school.’

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